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MARION COU ,NTY BUILDING iNSPECTION <br />SENATOR 13LDGL NO. 22,5 <br />220 HIGH STREET NE <br /> SALEM, OREGON 97301 <br /> <br /> PHONE: 588-5147 8:00 - 4;30 <br />24 HOURICODE"A"PHONE: 588-7904 <br /> <br />SIGNATURE OF APPLICANT: ...................... <br /> DX'~E: ................................. <br /> <br />ow.~; IM'IF~ 03/24/94 TIM~'~ I1:~2:~ ....... tl~'~ot~ ............................ :,'~o~¥; <br /> ' ~ES.I,D.~NJI L <br /> 0~ }{~ES ~C ;' .... ' ............................................ ' CONSTRUCTION T~PE: <br /> <br /> 14614 K~EL CT m NE , <br />, AURORA · OR ~2 ..... ':. AUEORA , N~ i <br />· u~ o~ ~O~c~; .' ........ ; .................. ~)""' '. ............................ ~ .................................................. .................................. <br /> <br /> PHONE: <br /> <br /> ...... ~,.~ ........ <br /> <br />. ~12 ~ .................. ~4. ...... ~3~ ........ ~E ............ ,..~ .... 0 <br /> <br />~ONTRACTOR~ <br />Stanley M Kei~ht].e~ <br />1364~ Oek Rd NW ' <br /> <br /> 868-7388 , <br /> <br /> ITEM <br />STANDARD ON-SITE ~STEM <br /> <br /> PAYEE: <br /> RECEIVED DY~ P3 <br /> <br /> SEE ATTACHED DOCUmeNT ~OR'REG <br /> ~ THI~, IS A VALI~ PE~IT ~"T <br />CO~ST~UC rlOH FaI[,~S TO HEET <br />ZO,~IN~ ORDINANCES~ T~l~ PER~T <br /> <br />TEST HOLES REAOY: <br />SITE EVALUATIOH NUMBER: KASEL CT <br />EXISTING TANK ~IZE~ <br />EX~ST~NG ~R~IN FIELD <br />SEP'r~c TANK PUMPED~ <br />PREVIOUS NO. '~E~R00MS: <br /> <br />QUANTITY AMOUNT <br /> <br /> TOTAL A~SESSED FEES $255.00 <br />: .PRE~IOU$'EECEIPTS <br /> THIS RECEIPT <br /> <br /> ......... INVOICE NO: <br /> _ cH cK <br />J~R~N£~T8 'OF,"O~-S~TE .SEWAGE SYSTEM. <br />~IS' PERH~T '~IRE8 ~6~ DAY~ F~H IT~ I~SUE DATE- IF <br />~E~U'IREHENT5 OF ~TATE 'LA~ ~ND HA~ION COUNTY ~UIL~ING A.ND <br />~HflLL ~E~OME NIILL AH~ VOID, <br /> <br />, REHARKS: ST9 ,SYSTEM <br /> DONA[J) E. WOODLEY~ NARIOh) COUNTY <br /> <br />OFFICIAL / BY <br /> <br />OFFICE COPY <br /> <br /> <br />